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Thread: Enoxaparin More Effective Than Heparin in Preventing Thromboembolism After Spinal Cord Injury

  1. #1
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    Enoxaparin More Effective Than Heparin in Preventing Thromboembolism After Spinal Cord Injury

    Enoxaparin More Effective Than Heparin in Preventing Thromboembolism After Spinal Cord Injury
    A DGReview of :"Prevention of venous thromboembolism in the acute treatment phase after spinal cord injury: a randomized, multicenter trial comparing low-dose heparin plus intermittent pneumatic compression with enoxaparin."
    Journal of Trauma® Injury, Infection, and Critical Care

    07/02/2003
    By Emma Hitt, PhD


    Enoxaparin appears to be more effective than unfractionated heparin (UFH) in the prevention of thromboembolic complications after spinal cord injury, although both interventions appear to be equally safe.

    Few studies have evaluated the risk of venous thromboembolism (VTE) or the effectiveness of thromboprophylaxis during the subacute or rehabilitation phase after spinal cord injury.

    In a prospective, multi-centre, non-randomised study, Geno Merli, MD, with Jefferson Internal Medicine, Philadelphia, Pennsylvania, United States, and colleagues compared prophylactic low-dose UFH with enoxaparin during the rehabilitation phase after spinal cord injury.

    After 2 weeks of acute-phase prophylaxis, patients without objective evidence of VTE entered the rehabilitation phase and received up to 6 additional weeks of thromboprophylaxis with either UFH 5,000 U every 8 hours or enoxaparin 40 mg once daily. Patients then underwent repeat bilateral lower extremity duplex ultrasonography.

    The researchers found that among 119 patients who completed the rehabilitation phase and had adequate imaging, new VTE was observed in 13 of 60 UFH versus 5 of 59 enoxaparin patients (21.7% vs. 8.5%; p = 0.052). None of the major clinical variables assessed were predictive of VTE, and there were no between-group differences in these assessments.

    In terms of safety, both anticoagulant regimens were associated with a low incidence of major bleeding and other adverse events, and only one patient from each group discontinued treatment because of bleeding.

    "In this non-randomised comparison, enoxaparin appeared more effective than heparin in the prevention of thromboembolic complications during rehabilitation after spinal cord injury," the researchers conclude. "Our findings confirm earlier reports indicating that the risk of VTE is high in both the acute and the rehabilitation phases after such injuries," they add.
    J Trauma Injury Inf Crit Care 2003;54:6:1111-1115. "Prevention of venous thromboembolism in the acute treatment phase after spinal cord injury: a randomized, multicenter trial comparing low-dose heparin plus intermittent pneumatic compression with enoxaparin."

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    http://www.docguide.com/news/content...0Care&count=10

  2. #2
    Most SCI centers have been using this for a number of years instead of heparin.

    (KLD)

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